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Final clinical long case 11

Created: 7/4/2004

Long case

A patient presents for a radical nephrectomy for malignancy.  He has a history of chronic obstructive pulmonary disease, ischaemic heart disease, a pacemaker and requires haemodialysis. 

Full blood count, urea and electrolytes, chest X-ray, ECG, echocardiogram, pulmonary function tests


What is the transfer factor? (discussion re: the pulmonary function tests)
How would you assess this patient's volaemic status?
Would you consider an epidural? Discuss the pros vs cons
How would you optimise this patient preoperatively?

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